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PubMed2006

Sexual and reproductive health for all: a call for action.

At the United Nations International Conference on Population and Development in Cairo in 1994, the international community agreed to make reproductive health care universally available no later than 2015. After a 5-year review of progress towards implementation of the Cairo programme of action, that commitment was extended to include sexual, as well as reproductive, health and rights. Although progress has been made towards this commitment, it has fallen a long way short of the original goal. We argue that sexual and reproductive health for all is an achievable goal--if cost-effective interventions are properly scaled up; political commitment is revitalised; and financial resources are mobilised, rationally allocated, and more effectively used. National action will need to be backed up by international action. Sustained effort is needed by governments in developing countries and in the donor community, by inter-governmental organisations, non-governmental organisations, civil society groups, the women's health movement, philanthropic foundations, the private for-profit sector, the health profession, and the research community.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Reproductive Health Hazards in the Workplace: Guidelines for Policy Development and Implementation.

To provide occupational health professionals and employers with guidelines for reproductive health policy making, the authors-both of whom are obstetrician-gynecologists and occupational medicine physicians-review the history of and legal basis for U.S. policy on work and reproduction, delineate the goals and important elements of a reproductive health policy (RHP), and emphasize the need to incorporate an RHP into a comprehensive occupational injury and illness prevention program. After suggesting practical ways to achieve the goals of an RHP (maximal health protection, compliance with legal mandates, and reduction of liability), the authors propose a team-based model for RHP implementation with shared responsibility of management and workers in designing, enforcing, and evaluating the policy.

Journal Article↗
PubMed2006

Religious leaders' perceptions and support of reproductive health of young people in Anambra State, Nigeria.

OBJECTIVES: This article assesses religious leaders' perceptions of young people's reproductive health in Anambra State. PATIENTS AND METHODS: Through self-administered semi-structured questionnaires, and in depth interviews, religious leaders perceptions of young peoples reproductive health in Anambra State Nigeria was elicited from two hundred and fifty religious leaders selected by multistage random sampling. RESULTS: Over 85% of the religious leaders thought that young people are sexually active, and are involved in high risk behaviour for unintended pregnancy, unsafe abortion, and STD and HIV/AIDS. Eighty five per cent felt that there is need for sexuality education in schools, and that sexuality education will reduce unintended pregnancy, abortion, STDS and HIV/AIDS among young people. However 52.2% felt that sexuality education in school would increase promiscuity. Some religious leaders did not support teaching of contraception and safe abortion in schools. CONCLUSION: Religious leaders in Anambra State have a high awareness of young people's reproductive health problem, and are in support of sexuality education in schools. They differ however in what should be the content of the curriculum. There is need to harmonise and agree on programme contents to minimise sending conflicting and confusing messages to young people.

Adult↗
PubMed1999

Legal issues in the reproductive health care of adolescents.

There is significant evidence that both physicians and adolescents are uninformed of adolescents' legal rights to confidential reproductive health care. When young people are aware of their right to confidentiality and assured that physicians will respect that right, they are more likely to seek care. Restricting adolescent reproductive health care places added stress on young women, delays treatment, and may even lead young women to resort to dangerous alternatives. The legal framework governing minors' ability to obtain confidential health services is key. This paper will identify recent threats to adolescent reproductive health care, analyze informed consent and confidentiality in the context of adolescent care, review minors' constitutional rights, and review the legal framework governing adolescent care in New York State as one example.

Adolescent↗
PubMed2000

Reproductive health services in rural Washington State: scope of practice and provision of medical abortions, 1996-1997.

OBJECTIVES: This study explored reproductive health care in rural Washington State, reasons given by providers for not offering abortions, and providers' willingness to use medical abortifacients. METHODS: Physicians, midwives, nurse practitioners, and physician assistants in rural Washington completed an inventory of reproductive health services that they provide, whether and why they do not perform abortions, and whether they would use medical abortifacients. RESULTS: Of the respondents, 89.2% reported providing reproductive health care. Only 1.2% reported performing surgical abortions, and 26.1% indicated that they would probably prescribe medical abortifacients. CONCLUSIONS: Few providers offer surgical abortions in rural Washington. Greater numbers report a willingness to prescribe medical abortifacients.

Abortifacient Agents↗
PubMedDate not supplied

The effects of smoking on the reproductive health of men.

This article discusses the impact smoking can have on men's sexual and reproductive health. There is evidence to suggest that smoking can result in alterations of the male sex hormones and is a key cause of and contributor to erectile dysfunction. Smoking can therefore endanger the man's ability to have a family and enjoy sexual activity. A reduction in sperm quality and a reduced response to fertility treatments has also been linked with those men who smoke. The damaging effects of smoking are apparent throughout the lifespan of a smoker. The benefits associated with cessation of smoking are wide and varied with respect to the reproductive health of men; these benefits can include a reduction in the risk of male impotence and an improvement in sexual potency.

Age Distribution↗
PubMedDate not supplied

The sexuality connection in reproductive health.

Sexuality and power relations based on gender are relevant to researchers, policymakers, and service providers in the reproductive health field, because they underlie virtually all of the behaviors and conditions that their programs address. Yet, a review of conventional treatments in the demographic and family planning literature reveals that, when they consider these topics at all, researchers typically adopt narrow definitions of sexual behavior and focus almost exclusively on risks of pregnancy and disease. This article proposes an analytic framework as a guide to researchers and family planning providers. It relates four dimensions of sexuality to reproductive health outcomes and concludes that family planning policies and programs should address a broader spectrum of sexual behaviors and meanings, consider questions of sexual enjoyment as well as risk, and confront ideologies of male entitlement that threaten women's sexual and reproductive rights and health.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Evaluating technologies in reproductive health: case studies of a consumer protection approach.

OBJECTIVE: A consumer-protection assessment and action program aimed at improving reproductive health technologies is reviewed. METHODS: Evaluations employed both literature review, synthesis, market analysis and laboratory testing for conformity to standards of a wide range of products which affect reproductive health on the Brazilian market 1995-1997. Anti-infective gynecological products, ampicillins, condoms, pregnancy tests, hormonal contraceptives, infant formulas, selected teratogens, bromocriptine and prostaglandins were studied. Actions include dissemination in periodicals and the mass media, consumer education, pressure for regulation, negotiations with manufacturers and legal action. RESULTS: The program was effective in improving the supply and regulation of some, but not all products studied. Impact on health and utilization are unknown. CONCLUSION: A significant proportion of products studied are unsafe, ineffective or of sub-standard quality. A combination of careful scientific work, strong links between scientists and social movements, dissemination and legal action, can effectively improve the quality of products which affect reproductive health.

Brazil↗
PubMed2005

Reproductive health and the Millennium Development Goals: the missing link.

This report was commissioned by the Population Program of the William and Flora Hewlett Foundation in December 2004. The author was charged with analyzing the United Nations' deliberations that led to the adoption of the Millennium Development Goals (MDGs) to answer the question of why there is no specific reproductive health goal. Her report, of which this is a lightly edited version, is also available online at . This coverage of the MDG process will be complemented by a special section of Studies in the June 2005 issue on reproductive health and the MDGs. The section will include excerpts about reproductive health from the final report of the Millennium Development Project entitled "Investing in Development: A Practical Plan to Achieve the Millennium Development Goals," which was submitted to Secretary General Kofi Annan in January 2005, as well as commentaries by leading scholars and policymakers in the fields of population and reproductive health.

Family Planning Services↗
PubMed2001

Sexually transmitted infections and reproductive health in Azerbaijan.

BACKGROUND: Little is known about the prevalence of sexually transmitted infections (STIs) and about sexual and reproductive health in Central and Eastern Europe. However, it is clear that major epidemics of STIs currently exist. GOAL: To provide baseline information for the development of national guidelines on the management of STIs in Azerbaijan. STUDY DESIGN: A prevalence study on STIs, including a questionnaire on sexual and reproductive health, in two regions of Azerbaijan targeted three groups: (1) pregnant women, (2) gynecology patients, and (3) men attending a dermatovenereology clinic. RESULTS: The 407 pregnant women in this study had a mean of 1.47 abortions and 1.40 births per woman. Of these women, 12% reported condom use and 41% previous symptoms of a sexually transmitted infection. Active syphilis was found in 1.7% of the women. The 326 gynecology patients had a mean of 2.54 abortions and 2.63 births per woman. Of these patients, 11% reported use of modern contraceptives, 18.3% previous condom use, and 63% previous symptoms of an STI. The prevalence of active syphilis was 2.2%, Chlamydia trachomatis 3.1%, Neisseria gonorrhoeae 2.8%, Trichomonas vaginalis 7.1%, Candida 33.1%, and bacterial vaginosis 32.5%. Of the 197 male patients, 67% reported multiple partners in the past 3 months, 62% money exchanged for sex, 37% condom use ever, and 40% a history of STIs. Active syphilis was found in 9.5% of the men, C trachomatis in 5.9%, N gonorrhoeae in 17%, and T vaginalis in 4.4%. CONCLUSIONS: The data show high-risk behavior in the men attending STI clinics, poor sexual and reproductive health status in the women, and underreporting of official data.

Adolescent↗
PubMed2006

Development of standardized Midwifery Nursing Reproductive Health Data Set (MN-RHDs) for Pakistan.

UNLABELLED: Pakistan has a marked discrepancy between reported and unreported maternal mortality, morbidity and reproductive health figures. Pakistan's figures are listed in the "E" category by the World Health Organization meaning there is no official means of data collection and reporting. PURPOSE: The purpose of this study was to develop the standardized "Midwifery Nursing Reproductive Health Data Set (MN-RHDS)" to provide systematic information about Pakistan's maternal mortality, morbidity, reproductive health, midwifery practices, and patient outcomes. METHOD: The descriptive data elements and definitions were generated and validated through Delphi survey and consensus conference of 25 experts. DATA COLLECTION: The experts rated each element on necessity, clarity of definition, and collectability. FINDINGS: Elements were categorized as follows: 1) Antenatal, 2) Labor and Delivery, 3) Postnatal, 4) Demographics, 5) Service Data, 6) Maternal Death, 7) Referral, and 8) Maternal Status. Elements related to task work compared to psychosocial nursing care achieved higher means with lower standard deviation. CONCLUSIONS: The MN-RHDS impacts data collection, storage, retrieval, and linkage of standardized information about reproduction interventions and outcomes in developing nations.

Female↗
PubMed1998

Effects of contraceptives on hemoglobin and ferritin. Task Force for Epidemiological Research on Reproductive Health, United Nations Development Programme/United Nations Population Fund/World Health Organization/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland.

The effects of combined oral contraceptives (OC), depot medroxyprogesterone acetate injections (DMPA), levonorgestrel subdermal implant (Norplant), copper-containing intrauterine devices (copper IUD), and Chinese stainless steel ring IUD on hemoglobin and ferritin were studied in 18-40-year-old, nonpregnant, and nonlactating women in seven countries (Bangladesh, Chile, China, the Dominican Republic, Pakistan, Thailand, and Tunisia). Data from 2507 women were analyzed. The study had a cross-sectional component in which 1295 current users of the contraceptive methods were compared with 1212 women initiating use of contraceptives. The results of this component showed that the current users of hormonal contraceptive methods generally had higher hemoglobin and ferritin levels than the noncontraceptors. The differences between women using hormonal contraceptive and noncontraceptors in mean values for hemoglobin varied between 3 and 6 g/L and for ferritin between 2 and 18 g/L. The current users of copper IUD had higher hemoglobin levels (difference in mean levels of 3 g/L), but lower ferritin levels (difference of 10 g/L) than noncontraceptors. Current use of the stainless steel ring had an adverse effect on both hemoglobin and ferritin. In a longitudinal component of the study, 285 anemic women (hemoglobin between 80 and 120 g/L at the time of initiation of contraception)--a subgroup of the cross-sectional component--were followed-up at 3, 6, and 12 months after initiation. In this component, significant mean increases of hemoglobin at 12 months were observed among the users of oral contraceptives and DMPA, but not among users of copper or stainless steel ring IUD. It is concluded that hemoglobin and ferritin levels are influenced by the use of contraceptives and that the hormonal contraceptives included in the present study have a beneficial effect on these parameters. The effects of copper IUD on hemoglobin and ferritin should be studied further.

Adolescent↗
PubMed2006

Reproductive health knowledge, beliefs and determinants of contraceptives use among women attending family planning clinics in Ibadan, Nigeria.

BACKGROUND: In developing countries especially in Africa, reproductive ill health have been a great concern to many stakeholders as maternal mortality and morbidity are very high compared to developed world. Also reproductive health knowledge and access to quality of care maternal health services in Africa are poor with significant health consequences. Appropriate reproductive health knowledge, belief and will power of women to access quality family planning services (preventive and curative) are essential for improvement in reproductive health of women. OBJECTIVE: The study aimed to assess reproductive health knowledge, beliefs and influential factors of contraceptives use among women attending family planning clinics in Ibadan, Nigeria. METHOD: The study was cross-sectional in nature involving 550 randomly selected respondents among women attending family planning clinics in Ibadan, Nigeria. The study instrument was a self-administered questionnaire. Data was analyzed using SPSS package. RESULTS: Only 56.0% of the respondents knew when pregnancy can occur, 31.5% believed that having sex once with a man will not result in pregnancy. Almost in all items, over 90.0% of respondents had knowledge of benefits of family planning. Consideration about personal health (86.0%) and husband's approval (74.9%) were major determinants of respondents use of contraceptives. CONCLUSION: Though respondents were knowledgeable about benefits of family planning, there is the need for continuous education of women about reproductive health issues and integration of men's participation in family planning programme to increase utilization of family planning services in Ibadan, Nigeria.

Adult↗
PubMedDate not supplied

[Application of epidemiology to the protection of reproductive health].

The paper discusses the use of epidemiologic research for the prevention of occupational exposures focusing the hazards to the reproductive health of workers. For reproductive risks already documented in previous studies and in the available data, what is now needed is to identify better strategies to prevention rather than undertake further studies. Research is still needed however to identify risks previously not known and to investigate their mechanisms of action. This can be achieved by undertaking studies that measure with more accuracy the exposure of workers and examine the complex interaction of these exposures on the male and female endocrine system and on the fetus. One area of particular recent interest is that of the effects of the EDCs on human reproductive health, with results that confirm the interference of these chemicals on various reproductive outcomes in experimental animals and in humans. Other uses of epidemiologic research on human reproduction are related to establishing and updating the limits of environmental and occupational exposures and in providing reliable and unbiased information to workers and the public.

Endocrine System↗
PubMed1991

Reproductive health: knowledge, attitudes and needs of adolescents.

OBJECTIVE: To determine the knowledge and attitudes of adolescents with respect to reproductive health, with particular emphasis on their knowledge of the symptoms and transmission of sexually transmitted diseases (STDs), preventive strategies and sources of information. DESIGN: Questionnaire survey of a stratified random sample of Year 10 students followed by group interviews with volunteers from the sample. SETTING: The study was carried out in 33 Victorian secondary schools. PARTICIPANTS: The questionnaire was administered to a stratified random sample of 1351 Year 10 students. Group interviews were conducted with 533 volunteers from the sample. MEASUREMENTS AND MAIN RESULTS: Considerable gaps were identified in knowledge of STDs and their short-term and long-term effects on reproductive health. An STD Knowledge Score was constructed based on responses to 46 items. The mean score for the full sample was 22.7 (49.3% correct) with a standard deviation of 6.4. As a group, country students scored better than city students (mean, 23.8 v. 22.2, t = 3.97, P less than 0.001) and females better than males (mean, 23.5 v. 21.9, t = 4.21, P less than 0.001). Medical practitioners were rarely identified as a source of preventive advice. CONCLUSION: The deficiencies identified in knowledge about reproductive health suggest that young people need better access to health information. Schools and the medical profession need to work together both to provide information and to help young people develop the confidence to use available information sources.

Adolescent↗
PubMed2006

Fertility regulation and reproductive health in the Millennium Development Goals: the search for a perfect indicator.

Although several key elements of sexual and reproductive health are included in the United Nations Millennium Development Goals, a measure of women's capacity to regulate their fertility safely and effectively is missing. We considered the usefulness of 3 pairs of indicators in monitoring this component of reproductive health: contraceptive prevalence and total fertility; unmet need for contraception and unplanned births; and unsafe abortion and abortion mortality. A single measure of contraceptive use is insufficient. The risks women face from unplanned births and unsafe abortion should also be incorporated into the monitoring process, either directly within the Millennium Development Goals framework or as a parallel effort by reporting governments and other agencies.

Abortion, Induced↗